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Physical Exam for Headaches

Topic Overview

A careful physical exam is needed to make sure the nervous system is
working normally and to discover clues about the cause of a person's headaches.
Results of the exam can help determine whether further testing is needed.

During the physical exam, the doctor will:

Check your temperature. If you have a fever, your
headache may be caused by an infection.

Check your blood
pressure.

Examine and feel your head for any evidence of injury or
painful areas (trigger points).

Examine inside your eyes for signs
of bleeding and increased pressure inside the eyes or head.

Examine
your nose and ears for signs of infection.

Examine your neck and
throat for swollen or tender glands, muscle spasms, and stiffness or limitation
of movement.

When the doctor checks your nervous system, he or she will:

Check your mental status. The doctor will check
to see whether you appear confused or disoriented in some way or function at a
lower level than expected.

Evaluate your balance. The doctor will check your
balance by asking you to stand with your eyes closed. He or she will also ask
you to walk in order to evaluate your balance and coordination. You may be
asked to repeatedly touch your finger to your nose.

Evaluate your
muscle strength and nervous system reflexes. The doctor will check the strength
of movement in your arms and legs and other parts of your body. He or she will
also check your nervous system reflexes with a slight tap of a special
instrument (percussion hammer).

During the physical exam, the doctor may decide to examine other
parts of your body to look for possible causes of the headaches. The doctor may
also ask about other health problems if he or she thinks your headaches are
related to another medical condition.

If you are having a headache during the exam, the doctor may notice
things that often occur with a specific type of headache:

Any abnormal results in the physical exam may suggest a possible
medical cause of headaches. Abnormal results may include:

Fever, which may point to an infection, such as
sinusitis. A headache with a fever, a stiff neck, nausea, and vomiting may
point to
meningitis,
encephalitis, or a brain abscess.

A
headache that began suddenly in a person who has not had headaches before, or a
dramatic change in an established headache pattern.

A headache that
follows any form of physical exertion, such as exercise, sexual activity,
coughing, or bending (these types of headaches usually are not caused by a
serious problem, but in some cases they can be caused by an
aneurysm).

Abnormal speech, eye movements,
walking, coordination, or reflexes.

Abnormal eye exam, which
means there may be increased pressure inside the head.

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